The prevalence of type 2 diabetes mellitus（T2DM）on a global scale has had a huge impact on public health. The pathophysiological mechanism of T2DM is closely related to the adipokines secreted by different regional fat depot.Visceral adipose tissue secretes more adipsin than subcutaneous adipose tissue.Adipsin，a cell signaling protein secreted by adipocytes，participates in the limited activation speed of the alternative complement pathway（AP）and plays an important role in pathological processes such as ischemia⁃reperfusion and sepsis. How⁃ ever，studies on the role and underlying mechanisms of adipsin in T2DM are not yet clear. Just as incretin provides cues from the gastrointestinal system，adipsin may signal along the fat⁃to⁃islet axis. This review systematically sum⁃ marizes the effect of adipsin on blood sugar regulation and the potential mechanisms from clinical practice to animal experiments，aiming to provide a new explanation for the pathogenesis of hyperglycemia caused by lipid metabolism disorders，and new ideas for the diagnosis and treatment of T2DM.

Monogenic diabetes（MD）covers a wide range of heterogeneous diseases，including neonatal diabetes，maturity onset diabetes of the young and syndromic diabetes. The genetic diagnosis of MD helps to achieve precise therapy. As clinicians pay more attention to genetic screening in diabetes，more MD patients are identified. However，currently，the medicines of MD are often off ⁃label used，and the relevant guidelines or consensus rarely describe the detailed timing and dosage of medication. Thus，the main clinical challenge is how to implement precise treatment for MD cases. This study aims tosummarize the clinical and genetic characteristics of MD and describe how to implement individualized treatment and genetic counseling for several kinds of MD with specific treatment methods.

Type 1 diabetes mellitus（T1DM）is an autoimmune disease characterized by the destruction of islet beta cells in the pancreas triggered by genetic and environmental factors. Over the past few decades，extensive familial and genome⁃wide association studies have revealed more than 50 risk loci in the genome. However，genetic susceptibility cannot fully explain the global increase in T1DM incidence，most likely due to the increasing influ⁃ ence of environmental factors，especially the gut microbiota. Recently，evidence from human subjects and animal models has revealed that the gut microbiota as an environmental factor is involved and plays an important role in the pathogenesis of T1DM. However，there are few studies on the analysis of the gut microbiota in children with T1DM. This article reviews the research progress of gut microbiota and T1DM.

The morbidity and mortality of diabetes have increased rapidly in recent years. The drugs aim⁃ ing to act on new targets to control type 2 diabetes mellitus（T2DM）is not uncommon. At present，12 different types of anti⁃diabetic drugs are available to be used，offering various treatment measures through all aspects of the mechanism of diabetes. As compared with traditional drugs，new hypoglycemic drugs are safer and more effective， and have a protective effect on heart and kidney，delaying the occurrence of diabetic complications. This article reviews the current drugs acting at new targets for the treatment of T2DM in order to provide guidance for clinical treatment of T2DM.

Objective To investigate the effect of genetic variations in glucagon ⁃like peptide ⁃ 1 receptor （GLP1R）on the efficacy of liraglutide monotherapy for patients with type 2 diabetes. Methods A total of 219 patients with type 2 diabetes who received liraglutide monotherapy were included retrospectively. Changes in HbA1c，fasting plasma glucose（FPG），weight，body mass index（BMI）and waist ⁃to ⁃hip ratio（WHR）before and after treatment was collected and analyzed. Additionally，the association between efficacy and genotype status of genetic variation in GLP1R was analyzed subsequently. And the mRNA expression of GLP1R according to geno⁃ type status of polymorphism was analyzed. Results Patients showed significant improvement in all indicators of diabetes and weight before and after liraglutide treatment. The results of association analysis between efficacy indi⁃ cators and A131P polymorphism in GLP1R showed that the changes of HbA1c，FPG，weight，BMI and WHR were more significant among patients with GG genotype，and all the differences were statistically significant（P < 0.01）. Furthermore，the HbA1c achievement rate of patients with GG and GA/AA genotype was 64.6% and 44.4% ， respectively（χ2 = 7.488，P = 0.006）. Additionally，the expression of GLP1R mRNA in patients with GA/AA geno⁃ type was relatively lower than that in patients with GG genotype，and it was statistically significant（t = 4.081，P < 0.001）. Conclusion Polymorphism of A131P in GLP1R might compromise the efficacy of liraglutide through the mediation of mRNA expression. And the conclusion should be confirmed in prospective clinical trials subsequently.

 Objective To investigate the safety and efficacy of polyethylene glycol loxenatide（PEX168） combined with metformin in newly diagnosed obese patients with type 2 diabetes mellitus（T2DM）. Methods Eighty newly diagnosed obese patients with T2DM in the Department of Endocrinology and Metabolism of Xijing Hospital were selected and divided into treatment group（n = 40）and control group（n = 40）by random number table method. The treatment group was given PEX168 0.2 mg once a week combined with metformin 500 mg three times a day，and the control group with metformin 500 mg three times a day. After 12 weeks，fasting blood glucose （FBG），2⁃hour postprandial blood glucose（PBG），glycosylated hemoglobin（HbA1c），fasting insulin（FINS）， body mass index（BMI），blood pressure（SBP/DBP），total cholesterol（TC），triglyceride（TG），high density lipoprotein cholesterol（HDL⁃C），low density lipoprotein cholesterol（LDL⁃C）and uric acid（UA）were observed. The glomerular filtration rate（eGFR），insulin resistance index（HOMA⁃IR）and islet β⁃cell function（HOMA⁃β） were calculated. Adverse reactions in the two groups were observed as well. Results After 12 weeks of treatment， the lever of FBG，PBG，HbA1c，BMI，SBP，DBP，TG，TC，UA，HOMA⁃IR in both groups were lower，espe⁃ cially in the treatment group（P < 0.05）. Significant decrease of LDL⁃C was observed in the treatment group，but not in the control group（P < 0.05）. Although there was no significant difference in HOMA⁃β and eGFR between the two groups after 12 weeks of treatment，both of them were improved from baseline. Conclusion For newly diagnosed obese patientswith T2DM，PEX168 combined with metformin can rapidly and effectively control blood glucose，improve islet cell function，body weight，blood pressure，blood lipids and uric acid，and has significant cardiovascular and renal benefits，without increasing the risk of adverse events.

Ketamine is a noncompetitive antagonist of the N⁃methyl⁃D⁃aspartate（NMDA）receptor and is the racemate of both the levorotatory and dextorotatory isomers. S⁃Ketamine is the dextorotatory isomer of ketamine and has twice affinity for the NMDA receptor than racemic ketamine，resulting in greater analgesic potency and fewer adverse effects. Studies have demonstrated that NMDA receptors are associated with the generation of acute pain and the development of chronic pain，and the use of S⁃ketamine in the perioperative period is a desirable strat⁃ egy that provides a non⁃opioid mechanistic route to analgesia，but its optimal route and method of use still require ongoing research. This article will summarize and review the recent literature related to perioperative analgesia with S⁃ketamine. 

Objective To investigate the effect of circ_0005276 targeted miR⁃557 on the proliferation， migration and invasion of rheumatoid arthritis synovial fibroblasts（RA⁃FLS）. Methods RT⁃qPCR was used to detect the expression of circ_0005276 and miR⁃557 in synovium of CIA rats. Si⁃circ_0005276，si⁃NC，pcDNA， pcDNA⁃circ_0005276，miR⁃NC，miR⁃557 mimic，si⁃circ_0005276+anti⁃miR⁃NC and si⁃circ_0005276+anti⁃miR⁃ 557 were transfected into RA⁃FLS，CCK⁃8，scratch healing and Transwell assay to detect the activity，scratch heal⁃ ing rate and invasion number of RA⁃FLS. Double luciferase report verified the targeting relationship between circ_ 0005276 and miR⁃557. Results Compared with the normal synovial tissue，the expression of circ_0005276 in synovial tissue of CIA rats was up⁃regulated（P < 0.05）and the expression of miR⁃557 was down⁃regulated（P < 0.05）. After interfering with circ_0005276，the optical density（OD），scratch healing rate and invasion number of RA⁃ FLS decreased significantly（P < 0.05），while the expression of miR⁃557 increased（P < 0.05）. The expression of miR⁃557 in RA⁃FLS was significantly decreased after overexpression of circ_0005276（P < 0.05）. The OD value， scratch healing rate and invasion number of RA ⁃FLS decreased significantly after overexpression of miR ⁃ 557 （P < 0.05）. Down⁃regulation of miR⁃557 expression significantly weakened the effect of interfering circ_0005276 expression on the OD value，scratch healing rate and invasion number of RA⁃FLS（P < 0.05）. Conclusion Inter⁃ ference with circ_0005276 could promote the expression of miR⁃557 by targeting，thus inhibit the proliferation，mi⁃ gration，and invasion of RA⁃FLS. 

Objective The research aimed to explore the effects of Electroacupuncture on osteoporosis and P53/P21 signal pathway in elderly rats. Methods Twenty⁃seven⁃month⁃old male SD rats were randomly divided into two groups：elderly group（n = 8），electroacupuncture treatment group（n = 8）. Six⁃month⁃old male SD rats were young group（n = 8）. The treatment group was treated with electroacupuncture intervention five times a week for a total of 8 weeks. All rats in each group were sacrificed at 8 weeks. The serum bone metabolism indexes（CTX⁃I， PICP）were detected by using ELISA system；Micro⁃CT scanner were performed to evaluate the microstructure of bone tissue；The expression levels of P53/P21 mRNA and protein were detected by RT⁃PCR and Western blot. Results The levels of serum CTX⁃I in elderly group were higher than the young group（P < 0.01），while PICP was lower than that in the young group（P < 0.01）. Electroacupuncture caused decrease in CTX⁃I and increase in PICP compared to the elderly group（P < 0.01）. The BMD，BV/TV，Tb.N of bone tissue in elderly group were significantly lower contrast with young group（P < 0.01），while the Tb.Sp in elderly group was significantly higher compared with young group（P < 0.01）. Compared with the elderly group，Electroacupuncture caused increase in BMD，BV/TV，Tb.N（P < 0.05）and decrease in Tb.Sp（P < 0.01）. The expressions of P53/P21 mRNA and protein in the elderly group were significantly higher than the young group（P < 0.01）. Compared with the elderly group，the expressions of P53/P21 mRNA and protein in the electroacupuncture treatment group were significantly reduced （P < 0.01）. Conclusion Electroacupuncture can effectively improve osteoporosis in elderly rats.The mechanisms may be to alleviate osteoblast aging and increase osteoblast activity by inhibiting P53/P21 signal pathway，so as to promote bone formation and reduce bone loss.

Objective To explore the effect of mycobacterium tuberculosis transmembrane protein Rv3737 on mycobacterium tuberculosis⁃infected macrophages autophagy. Methods The target gene of mycobacterium tubercu⁃ losis Rv3737 was amplified by PCR. Rv3737 and shuttle plasmid pMV261 were linked by T4 ligase to construct pMV261 ⁃ Rv3737，which was then verified by double enzyme digestion and sequencing. pMV261 ⁃ Rv3737 and pMV261⁃vector plasmids were electrically transferred into the mycobacterium smegmatis competent cells to construct over⁃expressed Rv3737 mycobacterium smegmatis strain（MS：：RV3737）and control strain（MS：：Vector）. The over⁃ expressed Rv3737 in the mycobacterium smegmatis strains was verified by PCR and Western blot. The effect of Rv3737 on the growth of mycobacterium smegmatis in vitro was evaluated by detecting OD600 with a spectrophotome⁃ ter. MS：：pMV261⁃RV3737 and MS：：pMV261 infected macrophages，the survival of mycobacterium smegmatis in macrophages was detected by colony forming unit（CFU）count，and the effect of Rv3737 on the survival of mycobac⁃ terium smegmatis in macrophages was investigated through Western blot and laser confocal analysis，which were used to detect the changes of autophagy⁃related protein LC3 II. Results RV3737 did not affect the growth of myco⁃ bacterium smegmatis in vitro，but promoted its survival in macrophages. Over⁃expressed Rv3737 significantly inhibited the expression of LC3 II，and the laser confocal results showed that the autophagy sites of LC3 II were significantly reduced after over ⁃expression of Rv3737. Conclusion Mycobacterium tuberculosis transmembrane protein Rv3737 may promote the survival of mycobacterium in macrophages by inhibiting macrophages autophagy，and thus it is expected to be a target of anti⁃tuberculosis drugs and provide theoretical data for the treatment of tuberculosis.

Objective To investigate the effect of complement C3 and TGFβ1/Smad signal pathway on synaptic plasticity and working memory impairment in sevoflurane ⁃ anesthetiezd elderly mice. Methods Ninety C57BL/6 mice were randomly divided into three groups including a control group，sevoflurane anesthesia group， and sevoflurane anesthesia plus complement C3 inhibitor group. Working memory was detected by Y⁃maze test and the mRNA expressions of C1q and C3 were detected by RT⁃PCR. Synaptic plasticity was assessed by long⁃term potentiation（LTP），and protein expression of the TGFβ1/Smad3 pathway was detected by Western blot. Results Sevoflurane anesthesia inhibited spontaneous alternation and decreased population spike（PS）amplitude in LTP. The mRNA expressions of C1q and C3 were increased，so were the protein expressions of TGFβ1 and Smad3. Complement molecule C3 inhibitors enhanced both spontaneous alternation and PS amplitude，while suppressed the mRNA expressions of C1q and C3 and the protein expressions of TGFβ1 and Smad3. Conclusions Sevoflurane anesthesia leads to a decline in working memory and synaptic plasticity in elderly mice，possibly through regulating the complement C3⁃mediated TGFβ1/smad signal pathway. 

Objective Radiotherapy is the standard treatment for nasopharyngeal carcinoma （NPC）. Increasing evidence shows that long non⁃coding RNA （lncRNAs） plays an important role in regulating cell radiosensitivity. However，the role of TUG1 in radiation resistance of NPC has not been studied. This study is to perform pan⁃cancer analysis of TUG1，and to evaluate its effect on biological behavior and radiosensitivity of NPC. Methods Expression and prognostic value of TUG1 in pan⁃cancer were detected based on TCGA database. qPCR was used to detect the expression of TUG1 in NPC tissues and NPC cell lines. CNE⁃1 and CNE⁃2 cells were trans⁃ fected with TUG1 siRNA or negative control siRNA. The proliferation，invasion and migration of NPC cells were detected by MTS，transwell and scratch test. The radiosensitivity of cells was measured by cell clone formation. The cell cycle and apoptosis were detected by flow cytometry. Results Analysis based on TCGA database showed that the expression of TUG1 was up⁃regulated in 12 cancer types. The increased expression of TUG1 was associated with poor prognosis in many types of cancers. In vitro studies showed that TUG1 was also significantly up⁃regulated in NPC cell lines and tissues. There was a significant association between TUG1 overexpression and worse TNM stage. Moreover，high expressionof TUG1 in NPC was determined to be a strongpredictor of short overall survival. Further investigation found that knockdown of TUG1 repressed proliferation，migration and invasion，promoted apoptosis， and improved radiosensitivity. Conclusion Our results reveal the important role of TUG1 in many types of cancers and it is related to the poor prognosis of NPC. TUG1may serve as novel targets for NPC therapy.

Objective The aim of this study was to investigate the effects and its mechanism of lncRNA NALT（NALT）on the injury of human lens epithelial cells induced by H2O2. Methods Human lens epithelial SRA01/04 cells were treated with different concentrations of H2O2 for 24 h，and the cell proliferation activity and NALT expression level were detected by CCK⁃8 and qRT⁃PCR. The NALT overexpression plasmid was transfected into SRA01/04 cells，and then treated with 100 μmol/L H2O2 or combined with 10 μmol/L Notch signaling pathway inhibitor DAPT for 24 h. The cell proliferation activity was detected by CCK⁃8. The level of ROS was evaluated by DCFH ⁃DA fluorescent probe labeling method. The SOD activity and MDA content were assessed by chemical method. The level of cell apoptosis was detected by Annexin V ⁃ FITC/PI method. The protein expression levels of Notch1 and Hes1 were evaluated by Western blot. Results With the increase of H2O2 concentrations，the prolifera⁃ tion activity and NALT expression level of SRA01/04 cells were decreased in a dose⁃dependent manner（P < 0.05）. After H2O2 intervention，NALT overexpression increased the proliferation activity and SOD activity of SRA01/04 cells，decreased the level of ROS，MDA and apoptosis，and up⁃regulated the protein expression levels of Notch1 and Hes1（P < 0.05）. However，combined DAPT intervention reversed the protective effects of NALT overexpression on SRA01/04 cell injury induced by H2O2. Conclusion Overexpression of NALT improved the injury of human lens epithelial cells induced by H2O2，and the mechanism may be related to the activation of Notch signaling pathway.

Objective To investigate the changes of spinal and pelvic parameters after multi⁃level lumbo⁃ sacral fusion in patients with degenerative lumbar spinal stenosis. Methods From June 2018 to June 2020，a total of 85 patients with multil ⁃level degenerative lumbar spinal stenosis underwent lumbosacral interbody fusion，and were followed for（24 ± 2.18）months，divided into balanced groups based on preoperative and last follow⁃up SVA （sagittal vertical axis，SVA）50 mm. SVA > 50 mm was classified as unbalanced group. Preoperative and last follow⁃up spino⁃pelvic parameters were measured，and the OSWESTRY disability index（ODI）and SF⁃36（the MOS item short from health survey，SF⁃36）scores were performed. The overall curative effect was evaluated according to the modified MacNab criteria at the last follow⁃up，and the changes of spinal and pelvic parameters and the clinical curative effect were statistically analyzed. Results In the preoperative group，the SVA of the unbalanced group was significantly improved before and after operation（P < 0.01），while there was no significant difference in the preoperative and postoperative changes of the balanced group. The ODI and SF⁃36 scores of both groups were improved after operation compared with those before operation（P < 0.01），and there was no significant difference between the two groups. In the postoperative group，there were statistically significant differences in ODI and SF⁃36 scores between the two groups（P < 0.01），and the balance group was better than the unbalanced group. There were statistical differences in △LL and △HOD/n（height of disc，HOD）of the lumbar department between the two groups（P < 0.01）. In 85 cases，△LL was positively correlated with △HOD/n（r = 0.73）. According to the modified MacNab standard，50 cases were excellent，22 cases were good，7 cases were fair，6 cases were poor， with an excellent and good rate was 84.7%（72/85）. Conclusion Decompression and fusion surgery is effective for multi⁃level degenerative lumbar spinal stenosis. Patients′ postoperative outcomes can be improved by restoring theheight of the intervertebral disc to increase LL and improve sagittal balance.

Objective To study the effect of point⁃through⁃point acupotomy on the range of shoulder joint motion and its long⁃term clinical effect on frozen periarthritis of shoulder. Methods Sixty patients with frozen peri⁃ arthritis of shoulder in our hospital were randomly divided into two groups using the random number table method： point⁃through⁃point acupotomyacupotomy group（n = 30）and traditional acupotomy group（n = 30）. The treatment cycle for both groups was once a week，4 times as a course of treatment. The clinical efficacy，VAS，range of shoulder joint motion（ROM）and shoulder function（Constan⁃Murley）of the two groups were evaluated on the first day after the treatment，the first month after the treatment，and the third month after the treatment. Results After the treatment，the total effective rate of the point⁃through⁃point acupotomy group was significantly higher than that of the traditional acupotomy group（P < 0.05）. The VAS scores of the two groups were significantly lower than those before the treatment respectively（P < 0.05）. The VAS score of the point⁃through⁃point acupotomy group was significantly lower than that of the traditional acupotomy group（P < 0.05）. The ROM of extension，flexion，adduc⁃ tion，abduction，and external rotation in the two groups were significantly higher than those before the treatment respectively（P < 0.05）. In addition，the extension，flexion，adduction，abduction and external rotation ROM of patients in the point⁃through⁃point acupotomy group were significantly higher than those in the traditional acupoto⁃ my group（P < 0.05）. Conclusion The point⁃through⁃point acupotomy is effective in treating frozen periarthritis of shoulder by reducing the degree of pain，improving the function and range of motion of shoulder joint，and ele⁃ vating the short⁃term and long⁃term rehabilitation of frozen periarthritis of shoulder.

Objective To investigate the association of early changes of quadriceps muscle thickness （QMT）with prolonged weaning in elderly patients with sepsis undergoing mechanical ventilation（MV）. Methods A prospective observational study was conducted and 329 elderly patients with sepsis undergoing MV admitted to the intensive care unit（ICU）in the Second Affiliated Hospital of Hainan Medical University from January 2021 to August 2022 were enrolled. The patients were assigned to prolonged weaning group（n = 93）and non ⁃ prolonged weaning group（n = 236）. The age，sex，body mass index（BMI），Charlson comorbidity index（CCI）score，sequen⁃ tial organ failure assessment（SOFA）score，acute physiology and chronic health evaluation Ⅱ（APACHEⅡ）scoreat ICU admission，and rapid shallow breathing index，duration of MV，laboratory indicators and organ support at the first spontaneous breathing trial（SBT）were recorded and analyzed. QMT was measured by ultrasound at MV startup and the first SBT，and the change rate of QMT was calculated. Univariate analysis，multivariate logistic regression analysis and receiver operating characteristic（ROC）curve were used to explore the relationship between QMT parameters and prolonged weaning in elderly patients with sepsis undergoing MV. And decision curve analysis was used to determine the clinical practicability of QMT parameters in predicting prolonged weaning in elderly patients with sepsis undergoing MV. Results A total 329 patients were enrolled and the incidence of prolonged weaning was 28.27% . The proportion of age ≥ 75 years and CCI score ≥ 3 points，APACHE Ⅱ score，SOFA score，length of stay in ICU，28⁃day mortality，and serum lactate level in the prolonged weaning group were higher or longer than those in the non⁃prolonged weaning group，while BMI was lower than that in the non⁃prolonged wean⁃ ing group，and the difference between the two groups was statistically significant（P < 0.05）. Multivariate logistic regression analysis showed that age ≥ 75 years（OR = 2.521，95%CI：1.270～5.001，P = 0.008），CCI score ≥ 3 points （OR = 2.139，95%Ⅱ：1.062～4.311，P = 0.033），the decreased value of QMT at the first SBT（OR = 0.383， 95%Ⅱ：0.280 ~ 0.524，P < 0.001），and the elevated change rate of QMT（OR = 1.355，95%Ⅱ：1.254～1.465， P < 0.001）were independent risk factors for prolonged weaning in elderly patients with sepsis undergoing MV. According to ROC curve analysis，the area under the ROC curve of change rate of QMT for predicting prolonged weaning in elderly patients with sepsis undergoing MV was 0.887（95% CI：0.848～0.919），which was signifi⁃ cantly higher than that of QMT at the first SBT（0.758，95%CI：0.758～0.803），with statistically significant differ⁃ ences（Z = 3.507，P < 0.001）. According to decision curve analysis，when the threshold value was 0.10-0.70， the net benefit rate of change rate of QMT for predicting prolonged weaning in elderly patients with sepsis under⁃ going MV was better than that of QMT at the first SBT. Conclusion QMT at the first SBT and change rate of QMT are closely related to the risk of prolonged weaning in elderly patients with sepsis undergoing MV，which could be used to predict the risk of prolonged weaning in elderly patients with sepsis undergoing MV，and the pre⁃ dictive efficacy and net benefit rate of change rate of QMT are higher than those of QMT at the first SBT.

Objective In the treatment of pelvic anterior ring fractures，the clinical efficacy of superior pubic branch intramedullary nail system and superior pubic branch hollow screw was compared. Methods The data of 64 patients with superior pubic branch fracture treated in the Department of Orthopaedics，people′s Hospi⁃ tal of Xinjiang Uygur Autonomous region from January 2021 to June 2021 were analyzed retrospectively. here were 18 males and 14 females in the study，with an average age of（49.52 ± 5.48）years，and 32 patients in the control group（hollow screws），with an average age of（52.43 ± 6.37）years. The two groups were compared in terms of operation time，intraoperative blood loss，intraoperative X⁃ray frequency，fracture healing time，and postoperative fracture reduction. Matta radiology standard was used to evaluate the reduction quality，and Majeed score was used to evaluate the recovery of pelvic function. Results The observation group had significantly fewer intraoperative fluoroscopies than the control group，and the observation group had a significantly higher rate of excellent and good postoperative Matta radiology standards than the control group.There was no significant difference in the average op⁃ eration time，operative blood loss，fracture healing time and Majeed score of the last follow⁃up between the observa⁃ tion group and the control group. Conclusion The application of pelvic anterior column intramedullary nail system in the treatment of superior pubic branch fracture has a clear clinical effect，is a minimally invasive procedure， and has a low risk of complications. It is the best procedure for superior pubic branch fracture.

Objective To study the correlation between osteocalcin（OC）level and cognitive function in patients with obstructive sleep apnea hypopnea syndrome（OSAHS），and observe the effect of noninvasive ventilator therapy on their cognitive dysfunction. Methods Ninety ⁃eight male patients with OSAHS，confirmed by polysom⁃ nography（PSG），were enrolled in the study：41 of them with mild⁃moderate symptoms were assigned as mild⁃moder⁃ ate group and 57 of them with severe symptoms as severe group. During the same period，another forty⁃two male subjects who were confirmed without OSAHS were enrolled as controls. All the subjects completed the Epworth sleepi⁃ ness scale（ESS）and underwent Mini Mental Intelligence scale（MMSE）test. Blood samples were collected from all the subjects for measuring OC and TAOC. Twenty ⁃ eight patients with severe OSAHS were voluntarily treated with continuous positive airway pressure（CPAP）. After six months，PSG was conducted，and the levels of serum OC and TAOC were measured. Results （1）The MMSE score of OSAHS patients was（24.76 ± 2.06），and that of the control group was（28.9 ± 1.67）. The serum OC level in the OSAHS patients was（19.04 ± 8.0）ng/mL，and that in the control group was（23.21 ± 9.4）ng/mL. The level of TAOC in the OSAHS group was 6.40（5.41，7.60）U/mL， and that in the control group was 8.08（7.08，9.29）U/mL. The differences in the MMSE score and the levels of OC and TAOC were all significant between the two groups（P < 0.05）.（2）As compared with the mild⁃moderate group，the levels of OC and TAOC were significantly decreased in the severe group. None of the MMSE scores showed significant difference between the mild⁃moderate group and severe group.（3）Among the twenty⁃eight patients with severe OSAHS，there were significant differences between pre ⁃ and post ⁃ CPAP in the MMSE score［（23.71 ± 2.42）vs.（24.64 ± 2.13），P < 0.05］，and the level of TAOC［（6.13（5.10，7.02）U/mL vs. 7.34（6.80，8.90）U/mL， P < 0.05］，but there was no significant difference in the level of TAOC between pre ⁃ and post⁃CPAP［（19.98 ± 8.60）ng/mL vs.（20.77 ± 7.76）ng/mL，P > 0.05］.（4）The OC level was positively correlated with the level of TAOC， MMSE score，memory，attention，and calculation ability among those OSAHS patients. Conclusion OSAHS patients are susceptible to cognitive dysfunction，which may be related to the decreased OC. Aggregatedoxidative stress works as a factor impacting OC. Noninvasive ventilation as a therapy is conducive to alleviating the oxidative stress and the cognitive function impairment. 

Objective To investigate the efficacy and safety of apatinib combined with PD⁃1 blockades for patients with advanced colorectal cancer（CRC）who failed in the therapy with the standard regimens and explored the potential prognostic factors. Methods In this retrospective study，a total of 43 patients with advanced CRC who were treated with apatinib plus PD⁃1 blockades were included in this study. The initial dosage of apatinib was 250 mg or 500 mg，and PD⁃1 blockades were the available PD⁃1 inhibitors approved in China. The data on the efficacy and safety were collected using the electronic medical record system of the hospital and all the patients were followed up regularly to assess the long⁃term prognostic data. Association analysis between progression free survival（PFS）and baseline characteristic subgroups was performed to explore the potential risk factors for prognosis. Results The best overall response of the combination regimen indicated that partial response was observed in 11 patients，the disease was noted stable in 20 patients and progressive 12 patients，yielding an objective response rate（ORR）of 25.6%（95%CI：13.5% ~ 41.2%）and a disease control rate（DCR）of 72.1%（95%CI：56.3% ~ 84.7%）. Furthermore，the prognostic data obtained from the subsequent follow ⁃ up suggested that the median PFS of the 43 patients was 5.8 months（95%CI：3.81 ~ 7.79）and the median overall survival（OS）was 10.3 months （95%CI：5.75 ~ 14.85）. The most common adverse reactions were fatigue，hypertension，diarrhea and hand⁃foot syndrome. Furthermore，the association analysis suggested that ECOG performance status and left ⁃ and right ⁃side colorectal cancer might be independent factors to predict the PFS. Conclusion The regimen of apatinib plus PD⁃1 blockades is potential in efficacy and acceptable in safety for patients with advanced CRC in subsequent⁃line therapy.ECOG performance status and tumor location might be potential risk factors to predict the PFS. The conclusion should be confirmed in prospective clinical trials subsequently.

Objective To investigate the clinical value of CD45 + CD3 + lymphocyte ratio，CD45 + CD64 + monocyte ratio，CD161+ cell ratio and 16 KD，38 KD，CFP⁃10，ESAT⁃6 and LAM tuberculosis antibody detection in the diagnosis of tuberculosis. Methods Flow cytometry was used to count the peripheral blood CD45+ mononu⁃ clear cells，CD45+ CD3+ lymphocytes，CD45+ CD64+ monocytes and CD161+ cells in 202 newly diagnosed pulmonary tuberculosis patients（tuberculosis group）and 120 healthy people（healthy group）. Protein chip technology was used to quantitatively detect the serum TB antibodies of patients with 16 KD，38 KD，CFP⁃10，ESAT⁃6 and LAM. The differences in the proportion of cells and the expression level of antibodies between the two groups were quanti⁃ tatively compared. Diagnostic test evaluation indexes were used to evaluate the clinical diagnostic performance. Results The rank sum test showed that CD45+ CD3+ lymphocytes，CD45+ CD64+ monocytes，CD161+ cells and the established tuberculosis infection risk index（RF）were significantly different between the two groups（P < 0.001）. The levels of 16 KD and LAM antibodies were significantly different between the two groups（P < 0.001）. There was no significant difference in the levels of 38 KD，CFP⁃10 and ESAT⁃6 antibodies between the two groups（P > 0.05）. The areas under the ROC curve for the diagnosis of pulmonary tuberculosis using 16 KD，38 KD，CFP10，ESAT⁃6， LAM，CD45+ CD3+ %，CD45+ CD64+ %，CD161+ % and RF were 0.748，0.525，0.564，0.535，0.680，0.860，0.834， 0.667 and 0.884. The optimal cut⁃off values were 1.031，1.074，1.075，1.062，1.161，78.480，14.250，34.765 and 0.469，respectively，and the diagnostic accuracy was 73.91%，54.04%，61.80%，51.55%，68.94%，64.29%， 79.50%，52.80% and 81.99%，respectively. Conclusion The detection of RF，CD45+ CD3+ %，CD45+ CD64+ % and 16 KD tuberculosis antibody has high clinical application value in the clinical diagnosis of pulmonary tuberculosis.